Is it rare to have a hole in your chest?

September 28, 2025 •

4 min read

While the idea may sound alarming, congenital heart defects involving a "hole in the heart" are relatively common, with approximately 1% of babies born in the United States having some form of congenital heart defect, though many are minor and close on their own. So, is it rare to have a hole in your chest? The answer depends heavily on the specific condition, ranging from chest wall deformities to internal cardiac issues.

Quick Summary

It's not rare to have certain kinds of "holes" in the chest, particularly with conditions like pectus excavatum, a chest wall deformity, or specific types of congenital heart defects that are often present from birth. Many are minor, non-symptomatic, and some close on their own, while others may require medical attention.

Key Points

Pectus excavatum is not rare: This congenital chest wall deformity, or sunken chest, affects a significant number of people and is more common than some other similar conditions.
'Holes in the heart' are also not rare: Many types of congenital heart defects, such as a Patent Foramen Ovale (PFO), occur frequently, and many remain asymptomatic.
Sternal foramen is rare: A naturally occurring, small hole in the breastbone (sternum) is a rare anatomical variant, discovered incidentally and usually harmless.
Symptoms determine severity: The true concern lies not in the existence of a "hole" but in the symptoms it causes, such as shortness of breath, chest pain, or heart palpitations.
Medical evaluation is key: A doctor can differentiate between a cosmetic chest wall indentation and a serious cardiac or esophageal issue through proper diagnostic tests.
Treatment options exist: Depending on the specific condition, treatments range from monitoring and physical therapy for mild cases to surgical correction for more severe ones.
Misconceptions are common: The public perception of a "hole in the chest" often doesn't align with the medical reality, which encompasses a variety of conditions with different causes and implications.

Understanding the 'Hole in Your Chest'

When people ask, "is it rare to have a hole in your chest?" they might be referring to several distinct medical conditions. The most common interpretations involve either a chest wall deformity, known as pectus excavatum, or a congenital heart defect (a "hole in the heart"). The rarity and severity of the condition vary significantly depending on which one is being discussed.

Pectus Excavatum: The 'Sunken Chest'

Pectus excavatum is the most common congenital deformity of the chest wall, affecting between 1 in 300 to 1 in 1,000 births, making it not particularly rare. This condition, also known as "funnel chest," causes the breastbone (sternum) to be sunken into the chest due to an overgrowth of cartilage connecting the ribs to the sternum.

Symptoms: For many, the only symptom is the physical indentation itself. In more severe cases, the chest can press on the heart and lungs, leading to symptoms like shortness of breath, chest pain, and a fast-beating or fluttering heart.
Prevalence: This condition is more common in males than females, with a ratio of about 3:1. It can become more noticeable during adolescent growth spurts.
Treatment: Mild cases often require no treatment. Severe cases may require surgical correction to improve heart and lung function and address cosmetic concerns.

Congenital Heart Defects (Holes in the Heart)

Congenital heart defects are common, with holes in the heart making up a significant portion. Here's a breakdown of the most common types:

Patent Foramen Ovale (PFO): All fetuses have a hole (foramen ovale) between the upper chambers of the heart. For some adults (15-35%), this hole doesn't fully close after birth, resulting in a PFO. Many people with a PFO are unaware of its existence as it often causes no symptoms.
Atrial Septal Defect (ASD): An ASD is a more significant hole in the wall (septum) between the heart's upper chambers. Secundum ASD, the most common type, occurs in the middle of the septum and affects a small but notable percentage of births. Small ASDs may close on their own, but larger ones may require intervention.
Ventricular Septal Defect (VSD): This is a hole in the wall separating the heart's lower chambers (ventricles) and is one of the most common congenital heart defects, especially in children. While small VSDs often close on their own, larger ones may cause symptoms like heart failure and require surgery.

Other, Rarer Conditions

In addition to the more common conditions, other, rarer occurrences can lead to the sensation or reality of a "hole" in the chest area:

Sternal Foramen: A small, naturally occurring hole in the breastbone (sternum) is a rare anatomical feature that is usually harmless but can be mistaken for an injury.
Esophageal Perforation: A rare and dangerous condition where a tear occurs in the esophagus. The most common cause is injury during a medical procedure, but it can also occur spontaneously due to forceful vomiting.
Pneumomediastinum: An uncommon condition where air leaks into the middle of the chest. It can result from increased pressure from coughing or trauma and can cause chest pain.

Comparison of Chest Wall and Heart Conditions

To clarify the differences, here's a comparison table of key characteristics for pectus excavatum versus congenital heart defects involving a "hole."


Feature	Pectus Excavatum	Congenital Heart Defect (e.g., ASD/VSD)
Location	External, affecting the breastbone and ribs.	Internal, affecting the septal wall of the heart.
Appearance	A visible, sunken depression in the chest.	No external sign; discovered through internal imaging.
Prevalence	Relatively common (approx. 1 in 300-1000 births).	Common (approx. 1% of births), though specific types vary.
Primary Concern	Cosmetic, and in severe cases, compression of heart/lungs.	Mixing of oxygen-rich and oxygen-poor blood; heart strain.
Diagnostic Method	Physical examination, confirmed by X-ray or CT scan.	Echocardiogram (ultrasound of the heart).
Treatment	Non-invasive (vacuum bell) or surgical correction (Nuss procedure).	Watchful waiting for small defects; surgery for larger ones.

When to Seek Medical Attention

While some "holes" like mild pectus excavatum or a small, asymptomatic PFO may not require treatment, it's crucial to consult a doctor if you or a child exhibits certain symptoms. Any chest pain, shortness of breath, or palpitations should be evaluated promptly. In the case of pectus excavatum, worsening symptoms or self-esteem issues due to the chest's appearance can also warrant a visit to a specialist.

The Role of Diagnosis

A proper diagnosis is essential to differentiate between these conditions and determine the correct course of action. For chest wall deformities, a physical exam is the first step, followed by imaging tests like X-rays or CT scans. For suspected heart defects, an echocardiogram is the definitive diagnostic tool. These tests allow doctors to assess the size and location of the defect and its potential impact on the body.

Conclusion

To answer the question, "is it rare to have a hole in your chest?" it is clear that it depends on the specific context. Pectus excavatum and various congenital heart defects are not uncommon, though their severity and associated symptoms can range from mild to life-altering. The idea of a 'hole' is more nuanced than a simple physical opening and requires a proper medical diagnosis to understand. If you have any concerns about your chest or heart, consult a healthcare professional for an accurate assessment and guidance.

For more detailed information on heart-related conditions, you can refer to authoritative sources like the American Heart Association.

Frequently Asked Questions

Yes, a hole directly in the breastbone, known as a sternal foramen, is a rare anatomical anomaly. However, the appearance of a sunken chest, caused by a chest wall deformity called pectus excavatum, is not rare.

Pectus excavatum is an external condition involving a sunken breastbone and ribs, while a "hole in the heart" (like an ASD or VSD) is an internal congenital heart defect in the wall dividing the heart's chambers. They are two different medical conditions with distinct causes and treatments.

In severe cases, yes. With severe pectus excavatum, the sunken breastbone can compress the heart and lungs, leading to symptoms like shortness of breath, chest pain, and heart palpitations. Congenital heart defects can also cause the heart and lungs to work harder, leading to issues if untreated.

No. Many small holes in the heart, such as a patent foramen ovale (PFO) or small atrial septal defect (ASD), may close on their own or remain asymptomatic throughout life. Larger defects that cause significant symptoms or complications may require surgical repair.

A hole in the heart is typically diagnosed using an echocardiogram, which is an ultrasound of the heart. This allows a doctor to visualize the heart's internal structure and assess any defects. A heart murmur heard during a physical exam can sometimes be the first clue.

Physical therapy and specific exercises can be beneficial for people with mild to moderate pectus excavatum to improve posture and breathing. However, they cannot correct the underlying skeletal deformity. Severe cases may require more intensive medical interventions like surgery.

The outlook is generally very positive. Mild cases of pectus excavatum may require no treatment. For severe cases, surgical correction has an excellent success rate, leading to significant improvement in both appearance and, when necessary, heart and lung function.